Ten relatives test positive for diphtheria in Palermo following death of unvaccinated child

Outbreak and contact tracing

Health officials at the local health authority (Asp 6) in Palermo confirmed that ten family members of four-year-old Anna Rosa Bartolotta tested positive for diphtheria. The girl died during the night between 20 August and 21 August at the Ospedale dei Bambini in the Sicilian capital. She had contracted the infection after her parents refused to immunize her against the disease. The department of prevention launched an epidemiological investigation on 16 August, the date when the child's infection was confirmed, to trace contacts and identify patient zero.

Initial testing focused on the child's immediate social circle, with health workers administering nasal swabs to 40 relatives and close friends. Most of the family members who tested positive are minors. Health officials reported that none of the infected relatives are in serious condition because they had previously received either a single vaccine dose or the full vaccination course. The positive individuals were placed in domestic isolation under prescribed antibiotic chemoprophylaxis. The child's four-year-old cousin was hospitalized in the infectious disease ward at Ospedale dei Bambini with an attenuated, tonsillitis-like form of the illness, where medical staff confirmed his clinical condition continues to improve.

We are carrying out various activities. First of all the epidemiological investigation to trace patient zero, that is the individual who transmitted the disease, and to trace all contacts.

Prophylaxis and vaccine supplies

Asp personnel extended testing and preventative antibiotics to all individuals who encountered the family, including attending medical personnel and investigators who interviewed neighbors. Health workers visited the family in person to administer antibiotic treatments directly after concerns emerged that prescribed regimens were not being followed properly. The girl's four siblings, who were also unvaccinated, received their vaccine doses under an administrative order issued by Asp following their sister's death.

Department officials expanded vaccine distribution across local public clinics to prevent broader transmission. Following reports from two regional clinics on Friday regarding low vaccine stocks, the agency dispatched supply vans from its central prophylactic storage. Prevention director Bruno Marsala stated that ample vaccine reserves remain in cold storage, with additional shipments scheduled for delivery.

Legal proceedings and parental inquiry

The Palermo Public Prosecutor's Office opened a criminal manslaughter investigation into the child's parents, coordinated by adjunct prosecutor Laura Vaccaro. Investigators placed both parents under formal investigation for manslaughter through omission. Authorities also initiated civil and juvenile proceedings through the Juvenile Prosecutor's Office regarding parental authority over the surviving children. An autopsy on the girl's body is scheduled for Wednesday, 26 August, at the Institute of Forensic Medicine at the Policlinico.

Investigators stated that the parents had rejected childhood vaccinations because of unfounded beliefs linking vaccines to autism. The mother rejected allegations of negligence in a social media statement, asserting that hospital staff failed to recognize the illness during multiple emergency room visits before the child died. She maintained that the precise cause of death remained unconfirmed prior to the autopsy results.

Neighborhood conditions and outreach proposals

The family lives in the ZEN district of Palermo, an area where local medical professionals report difficulties in maintaining standard childhood immunization schedules. Area pediatricians have noted persistent skepticism toward public health guidelines among some local residents. Parish priest Don Giovanni Giannalia, who met with the family after the child died, defended the parents against accusations of neglect.

Here one cannot speak of an ideological prejudice against vaccines, nor of a lack of care toward their children, but of people who simply needed to be supported.

Former Asp Palermo director Daniela Faraoni stated that vaccination coverage in the neighborhood remains difficult to maintain, noting that some parents submit appointment reservation slips instead of verified vaccination records. Faraoni called for an extraordinary organizational response using mobile healthcare units to reach residents who do not visit regional clinics. She added that mobile units should provide direct screenings, vaccinations, and psychological support for families.